Hey there Brea. They are not pleasant things are they!! I had one on my thigh in about '98. I was lucky in that it was picked up pretty quickly - a lump developed and being concerned I saw a doc who diagnosed it and sent me to a surgeon. After surgery just to be sure it was sent for analysis and was confirmed as a pilonidal cyst. First up the not-so-goods...surgery was a pretty big thing. Can't remember the exact dimensions but if the 'lump' was 20mm across they removed a 50x60mm rectangle around it and about 10mm deep. In other words the hole left in my leg was huuuge and I was really concerned about it healing. I should note that this was a chunk taken out of my leg and therefore it could not be sewn up in any way. The only benefit of this was that I had a sexy nurse come and change the bandage daily in my home for about 2 weeks....woohoo
Now the goods....surgery was a success as it has never come back. Secondly, the hole healed far better than I could've imagined. I am left with a slight indent and a pretty small scar considering the size of the wound. I know diabetics suffer from impaired healing but I have always healed pretty well and my D control is pretty good.
My advise would be to listen to the professionals advise. If they do recommend surgery as the only way to get rid of it, then my case is one example of it having the desired result.